The successful surgical management of a dog with a severed penis is reported. The principles and

technique of perineal urethrostomy in the dog are discussed

Wong, W. T.

Universiti Putra Malaysia Institutional Repository

Pertanika 7(3),47-48 (1984)Perineal Urethrostomy in a Dog "with a Severed PenisW.T. WONGDepartment of Veterinary Clinical Studies,Faculty of Veterinary Medicine and Animal Science,Universiti Pertanian Malay sia,Serdang, Selangor, Malaysia.Key words: Perineal urethrostomy; dog.RINGKASANSatu laporan tentang kejayaan merawat seekor anjing yang zakarnya luka parah. Prinsip dan teknikperineal uretrostomi pada anjing dibincangkan.SUMMARYThe successful surgical management of a dog with a severed penis is reported. The principles andtechnique ofperineal urethrostomy in the dog are discussed.INTRODUCTIONTrauma to the canine penis is not a commonproblem except during sexual activity when injurymay be inflicted by other dogs or irate owners(Wilson, 1975). Thus at this Veterinary TeachingHospital, common surgical manipulations of thepenis per se have been confined to excision oftransmissible venereal tumor lesions and correctionof paraphimosis. Bite wounds in hunting dogsinflicted by wild boars are presented occasionally.It is the objective of this paper to present a caseof traumatic penile amputation in a dog.HISTORYA one-year-old male dog of mixed breedwas presented with a history of having returnedhome the evening before with profuse bleedingfrom the prepuce. The owner had attempted tocontrol the bleeding with pressure on the prepuce.A bitch in the neighbourhood had been noticedin oestrus.RESULTSThe dog was depressed on presentation.The bleeding from the prepuce had stopped. Largeblood clots filled the preputial cavity and the peniswas not palpable. Examination under anaesthesiaand surgical intervention were scheduled pendingresults of a complete blood count and blood ureanitrogen (BUN). The results revealed a hematocritof 28% and a BUN of 32.6mg%.47Anaesthesia was induced with thiopentonesodium and maintained with oxygen and halo-thane. A lactated Ringer's intravenous drip wasalso set up. Examination of the preputial cavitywith the aid of a vaginal speculum failed to locateany remnants of the penis. A ventral midlineincision was made anterior to the scrotum andthe preputial cavity exposed. Oedema and con-tusion of the surrounding soft tissue were evident.The preputial mucosa was torn at numerous sitesand the stump of the penis was observed protru-ding I mm from the caudal reflection of the pre-putial mucosa. The end of the stump h~d a clean,perpendicular cut surface with the urethral orificevisible. The urethra was catheterised and 250 mlof urine aspirated.An enlargement of the urethral orifice on thepenile stump was made by spatulating the urethralmucosa and suturing it to the corpus spongiosum.The tears in the preputial mucosa were repairedand the skin incision closed with non-absorbablesutures. The dog was also castrated.The following morning, it was noticed thatwhenever the dog made an effort to urinate, theinguinal region swelled and was warm. Urineseepage into the subcutaneous space had occurredand emergency surgery was indicated. It wasdecided to carry out a perineal urethrostomyrather than a scrotal urethrostomy because of therisk of poor healing associated with the trauma atthe prepuce.W.T. WONGThe dog was placed on dorsal recumbencyto expose the stump of the penis for catheteriza-tion. Another 220 ml of urine was withdrawn.A 3 cm midline skin incision was made betweenthe anus and the scrotum. The urethra was identi-fied by palpating for the catheter. After separatingthe fibers of the bulbocavernosus muscle, the ure-thra was incised. The mucosa together with partof the corpus spongiosum were sutured to the skinwith care taken to achieve good apposition withthe skin. A scrotal ablation was also performed.An indwelling catheter was left in place. The dogwas maintained on a systemic antibiotic. Toprevent self-inflicted trauma to the urethrostomysite an Elizabethan collar was used and a tranquil-lize~ given for 7 days. The dog recovered une-ventfully and when examined 8 weeks later didnot show any evidence of stricture or urine scald.DISCUSSIONUrethrostomy in dogs is not a commonlyperformed procedure because of the inherent dan-gers of stricture and urine bums (Brown, 1975;Yoshioka and Carb, 1982). In a survey of the sur-gical cases in 78 small animal practices in Cali-fornia in which a total of 10,088 operative proce-dures were performed, no urethrostomies in dogswere recorded (Vasseur et al., 1981). It is impossi-ble to draw any conclusion from the one casereported here, but from this experience and thosereported in the literature, it would appear thaturethrostomics in dogs can be rewarding if certainimportant guidelines are followed. These includeminimal tension at the urethrostomy site, accurateapposition of urethral mucosa to skin margins andthe use of collars to prevent licking and self-mutibtion (Yoshioka and Carb, 1982; Smith andSchiller, 1978).The use of an indwelling urinary catheterto maintain a patent urinary passage while theurethrostomy site heals is a valic;l consideration.However, care should be exercised in choosing thesize of the catheter because overstretching of theurethral wall can produce stricture (Weaver andSchulte, 1962).From the history and clinical examination ofthe penile stump, it is highly probable that thepenis had been amputated with a sharp cuttingedge. However, the question as to whether thiswas iatrogenic or accidental remains unanswered.REFERENCESBROWN. S.G. (1975): Surgery of the canine urethra.Vet. Gin. North Am. 5 : 457470.SMITH. C.W. and SCHILLER. A.G. (1978): Perinealurethrostomy in the cat: a retrospective study ofcomplications. J. Am. Anim. Hosp. Ass. 14 : 225-228.VASSEUR, P.B., BERGER. B. and LEIGHTON. R.L.(981): The volume and distribution of surgicalcases in 78 sman animal' practices in California.J. Am. Anim. Hosp. Ass. 17: 161-166.... WEAVER, R.G. and SCHULTE. J.W. (1962): Experi-mental and clinical studies of urethral regeneration.Surg. Gyn. Obst. 115 : 729-736.WILSON. G.P. (1975): Surgery of the male reproductivetract. Vet. Gin. North Am. 5 : 537-550.YOSHIOKA, M.M. and CARB, A. (1982): Antepubicurethrostomy in the dog. J. Am. Anim. Hosp. Ass.18 : 290-294.(Received 9 June, 1984.)48

Perineal Urethrostomy in a Dog"with a Severed Penis

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Perineal Urethrostomy in a Dog"with a Severed Penis

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